Individual provider Active NPI

Brenna Faith Tescher, COTA

  • Gerontology Occupational Therapist
  • Williston, ND
National Provider Identifier
1386144129
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
395463 Issued in ND
Practice address
1705 3Rd Ave W
Williston, ND 58801-4119
Phone
(701) 572-6766
NPI assigned
Feb 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 395463 ND Primary

Addresses

Primary practice location

1705 3Rd Ave W
Williston, ND 58801-4119

Mailing address

1401 45TH St W # Appt307
Williston, ND 58801-1963
Phone (218) 201-1218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
395463NDMDGerontology Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1386144129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 45TH ST W # APPT307",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588011963",
            "telephone_number": "218-201-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 3RD AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588014119",
            "telephone_number": "701-572-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESCHER",
        "first_name": "BRENNA",
        "middle_name": "FAITH",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "ND",
            "license": "395463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.